One of the most important and controversial issues in medical law is “Physician Assisted Suicide”. During the recent decades it has been a challenging issue among the jurists, criminologists, doctors and even the patients themselves, as a part of the vulnerable population of society. This subject has had its own proponents and opponents. Core of these disputes is the “Right to Die” for the patients. This article has briefly criticized and analyzed this issue from the perspective of human rights doctrines.
Keywords: Human Rights, Right to Die, Assistance, Suicide, Medical Law.
Proponents of physician assisted suicide, among all human rights doctrines, generally emphasis on some discussions such as the right of freedom, the right of self-determination and in other words the autonomy. Autonomy is a principle used by proponents to justify this action. Based on this doctrine, everyone has the right to make a decision about his/her life freely.1 Considering the fact that the respect for patient’s autonomy is one of the four principles of medical ethics, proponents believe that implementation of autonomy corresponds to human dignity. The proponents’ argumentation is that the basis of respect for individual autonomy is paying respect to human value and dignity. This means a physician who with the request of patient releases him/her from pain, does two good actions:
Firstly, he respects the patient’s dignity and gives a good death to him/her.
Secondly, he follows the principles of medical ethics.
Therefore, an action that corresponds to human dignity and based on medical ethics is considered as a moral and correct action. This action is in accordance with human rights principles, i.e. the right of self-determination which considers human as a free creature that has the right to make a decision about her/his life.
About the necessity of protecting the right to life – that opponents emphasize on it too – proponents argue that life for those patients who live in a very low quality, that is hard to call them human, is not the life that is under support of human rights documents.
Some philosophers and jurists believe that life only has the “instrumental value” and some lives have not enough capability and value for being alive (Huxtable, 2007, PP.15-16). On the other hand, some proponents believe that those rules which support the right to life, only forbid government and others to give an end to a person’s life without his/her own request, but they don’t provide any prohibitions to give an end to person’s life, with his/her own permission (Leenen, 1989, PP.517-526 at P.519).
So physician assisted suicide doesn’t contradict these rules.
Opponents of physician assisted suicide generally emphasis on the right to life and necessity of its support and protection. To show their disagreement, they argue that life is the highest human value and when this value shapes as the norm, it is interpreted as the “right to life”.
The right to life is the most fundamental right of human and can be considered as the origin of human rights.
At present, the right to life plays an important role in international laws of human rights. For the first time, this right was introduced to international society in the article 3 of the UN Universal Declaration of Human Rights (10 December 1948). This article states that “Everyone has the right to life, liberty and security of person”.
Afterwards, some other laws have supported this right in various ways, such as article 6 of the International Covenant on Civil and Political Rights (16 December 1966), article 2 of the European Convention for the Protection of Human Rights and Fundamental Freedoms (4 November 1950), article 4 of the American Convention on Human Rights (22 November 1969) and also article 4 of the African Charter on Human and Peoples’ Rights (27 June 1981).
Opponents believe that these rules not only provide no exception for Euthanasia and physician assisted suicide, but also absolutely support the human life. So these actions contradict the right to life which is supported by above mentioned rules. In other words, unconditional protection of the right to life in human rights’ rules and documents shows that the prohibition against Euthanasia and physician assisted suicide is absolute and is not confined to a special way or person.
So either physician decreases life time of patient or doesn’t try to increase it or assists in his/her suicide, in all cases he/she has violated the right to life inserted in human rights’ documents.
Furthermore, about the necessity to respect the right of freedom and autonomy – that proponents emphasize on it too – opponents point out that firstly this freedom and discretion is not absolute and just according to moral values is acceptable. Secondly, this claim of the proponents that says the right to life is the same as other human rights, such as the right of freedom, doesn’t sound a right claim, because – as mentioned before – the right to life is the most fundamental right of human. So in contradiction of this right with other human rights, the right to life has priority and no other human rights, even the right of freedom, can prevail. In other words, the right of freedom can never be considered as a permission to end their own and others’ lives, because based on opponents’ belief, life is the highest level of goodness, and other good things get their meaning from life. Without life there is no goodness or value; they can’t be created because life is a necessary condition of other values creation such as freedom.
From the perspective of human rights doctrines, preventing suicide and helping to save a person who decided to commit a suicide, in fact, is protection of human life, and the right of self-determination doesn’t mean that individuals have the right to kill themselves. So preventing a person to commit suicide doesn’t contradict the right of self-determination and individual autonomy. Therefore, governments are obliged to provide a complete support of a person’s life who freely has decided to commit suicide and any neglect in this area can be considered as a violation of the right to life, because the right to life is the one that has three audiences: the person him/herself, other people and government. A person’s action in order to violate his/her right to life doesn’t mean that other people or government don’t have any responsibility to protect his/her life.
1 The concept of autonomy derived from Greek words “autos” and “nomos” meaning “self” and “authority” respectively (Hyland, 2002, PP.472-482).
Huxtable R (2007), Euthanasia, Ethics and the Law: From Conflict to Compromise, Routledge-Cavendish Press.
Hyland D (2002), “An exploration of the relationship between patient autonomy and patient advocacy: implications for nursing practice”, Nurse Ethics, 9(5).
Leenen H.J.J (1989), “Dying with Dignity: Developments in the Field of Euthanasia in the Netherlands”, Medicine and Law, 8(5).
Ali Izadyar, PhD Student in Criminal Law and Criminology, Shahid Beheshti University, Tehran, Iran